Global perspective on child and adolescent oral health: a systematic review and meta-analysis of oral impacts on daily performance.

OBJECTIVE: Several prevalence studies have estimated the region-specific impact of oral diseases on oral health-related quality of life. However, none of them reported and compared the same from a global perspective. This meta-analysis aims to evaluate pooled epidemiologic data about child-oral impacts on daily performance (C-OIDP) globally. METHODS: A search was conducted in PubMed, Science Direct, SciELO, Semantic scholar, and Cochrane databases up to January 2023. Studies evaluating OIDP among 11-18-year-olds were included in the review. Quality of the included studies was evaluated using the health states quality index for cross-sectional studies. The meta-analysis used R package software version 4.3.0. A common effect model was used to calculate the pooled prevalence. The protocol was registered in the PROSPERO (CRD-NIHR) database with Reference ID CRD42023393798. RESULTS: The systematic literature search yielded 257 unique citations. After screening titles and abstracts, 214 irrelevant citations were excluded, leaving 55 for full-text review. Overall, 43 studies from 23 countries were included. The meta-analysis reported a pooled prevalence impact C-OIDP of 53.36% (CI: 52.78-53.95, 43 studies, 16,622 participants). The prevalence of C-OIDP scores among South America, Asia, Europe, Africa and Oceania was 83%, 63%, 58%, 33% and 47%, respectively. The maximum prevalence was reported in South America while the least prevalence was noted in the African population. CONCLUSION: Oral diseases affect the oral health-related quality of life of more than half of children and adolescents globally. Huge variations were noted in the prevalence of oral impacts across different regions. These findings can be utilized by policymakers to draft measures required for reducing impacts of oral diseases and improving the health-related quality of life.

Oral manifestations, risk factors and management strategies of COVID-19 associated mucormycosis in tertiary care hospital.

Background: Mucormycosis (black fungus) is an aggressive, life-threatening infectious disease-causing infiltration and by destroying the surrounding bone and soft tissue through vascular thrombosis and subsequent tissue infarction that may reach the brain with fatal complications. Its outbreak has been assessed around the clock during the recent pandemic as post COVID-19 sequelae. Aims: To assess the risk factors, oral signs and symptoms, investigations, treatment and rehabilitation strategies amongst COVID-19 associated mucormycosis patients in a tertiary care hospital. Methods and Material: An observational, pilot study was carried out amongst 30 active or recent COVID-19 associated mucormycosis patients reporting in the Department of Dentistry of a tertiary care hospital in Bhopal over a period of 6 months. Statistical analysis was done using Kolmogorov-Smirnov test using the Statistical Package for Social Sciences, Version 16 software. Results: Study was done on 30 patients (80% males and 20% females) and their median age was 46 years. Predominant risk factor present was diabetes mellitus (90%) and steroid therapy (60%). Prime oral manifestations were toothache (90%), mobile teeth (83%), draining sinus (53%), palatal ulceration (43%) and para-sinusal pain (37%). Conclusions: Mucormycosis can cause serious oro-facial morbidity and mortality in COVID-19 patients. The current management strategy requires early diagnosis, prompt treatment and oral rehabilitation.

Effect of premature loss of primary teeth on prevalence of malocclusion in permanent dentition: A systematic review and meta-analysis.

OBJECTIVE: This systematic review and meta-analysis aimed to assess the effect of premature loss of primary teeth in children of mixed dentition age on the prevalence of malocclusion in permanent dentition. MATERIAL AND METHODS: A search was conducted in Medline through PubMed, Cochrane databases, Google Scholar, and Directory of Open Access Journals (DOAJ) through March 2023. All observational studies that evaluated the association between premature loss of primary teeth and malocclusion in permanent dentition were included for analysis. Quality of studies was evaluated using the Newcastle-Ottawa tool. Meta-analysis was conducted using Cochrane Review Manager (RevMan) Version 5.3. The association between different categories of malocclusion and premature loss of primary teeth was assessed using a random-effects model. Heterogeneity was explored through sensitivity analysis. Certainty of evidence was evaluated using GRADE analysis. RESULTS: This meta-analysis showed that the premature loss of primary teeth significantly increases the prevalence of overall malocclusion in permanent dentition (OR=2.54, P=0.003; I2: 83%). Subgroup analysis showed an insignificant relationship of premature loss of primary teeth with Class I malocclusion (OR=1.14, P=0.45; I2: 63%) and Class II malocclusion (OR=1.63, P=0.18; I2: 87%) but statistically significant relationship with Class III malocclusion (OR=3.73, P=0.006; I2: 71%). Sensitivity analysis reflected a significant reduction in I2 values. CONCLUSION: This meta-analysis provides substantial evidence supporting the relationship between premature loss of primary teeth and malocclusion in permanent dentition. Notably, Class III malocclusions exhibited a significant association with premature loss of primary teeth.

Straight lift technique as an alternative to surgical extraction of an intact, partially impacted mesioangular mandibular third molar.

Impacted mandibular third molar removal is the most common procedure performed by oral and maxillofacial surgeons. An array of alternative procedures have been suggested, like operculectomy in cases of pericoronitis and coronectomy in certain cases. However, these procedures pose several disadvantages, and we propose a relatively non-invasive 'straight lift technique'. This technique is specifically useful in straightening abnormally positioned mesioangular third molars as a substitute of complete removal. This can improve tooth function, eliminate the need for surgical intervention, and reduce the risk of complications associated with third molar removal.

Maxillary Incisor Intrusion Using Mini-Implants and Conventional Intrusion Arch: A Systematic Review and Meta-Analysis.

The aim of this analysis was to evaluate the maxillary incisor intrusion and change in overbite achieved by micro-implants compared to Connecticut intrusion arches among post-pubertal patients with deep bite. Medline, PubMed, Cochrane, and Google scholar were searched for studies falling under the inclusion criteria. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) com- paring maxillary incisor intrusion among post-pubertal deep bite cases treated by mini-implants and Connecticut intrusion arches were to be included. Outcome data were extracted using guidelines published by the Cochrane Collaboration. A systematic review was conducted using Cochrane Program Review Manager, version 5. A random effects model was used to assess the mean difference in the amount of incisor intrusion and overbite correction achieved between the 2 methods. Statistical significance was set at P < .05. Assessment of certainty of evidence was conducted using GRADE analysis. Six trials met the inclusion criteria. Mean differences for incisor intrusion -0.67 [95% CI, 0.97, 0.38] I2 = 31%; P < .00001) and overbite correction -0.51 [95% CI, 0.85, 0.16] I2 = 50%; P = .004) achieved with mini-implants were found to be significantly effective when compared to the Connecticut intrusion arch. Low to mod- erate heterogeneity was noted for incisor intrusion and change in overbite analysis respectively. High certainty of evidence was noted for higher association of mini-implants with incisor intrusion and overbite correction. Our meta-analysis suggests that mini-implants are superior to the Connecticut intrusion arch with respect to the amount of incisor intrusion and overbite correction. Further studies are still needed to confirm the superiority.

Maxillary Incisor Intrusion Using Two Conventional Intrusion Arches and Mini Implants: A Prospective Study.

AIM AND OBJECTIVE: This study aimed to compare cephalometrically the rate of maxillary incisor intrusion using mini implants, Connecticut intrusion arches, and segmental intrusion arches. MATERIALS AND METHODS: Thirty-two adult patients with deep bite were divided into three groups: 10 patients in mini implant and Connecticut intrusion arch group each and 12 patients in segmental intrusion arch group. Bilateral mini implants were used for intrusion in Group 1. Connecticut intrusion arch and Burstone's three-piece intrusion arch were used for intrusion in Group 2 and Group 3, respectively. Intrusion was carried out in all the patients for 4 months. Lateral cephalograms were taken just after alignment and leveling (T1) and after 4 months of intrusion (T2). RESULTS: The mean amount of intrusion observed was 1.7 mm (0.425 mm/month) in mini implant group, 1.4 mm (0.35 mm/month) in Connecticut intrusion arch group, and 1.66 mm (0.415 mm/month) in segmental intrusion arch group. No statistically significant difference was found in the extent of incisor intrusion in the three groups (p <0.05). CONCLUSION: The study failed to reject the null hypothesis, and there was no statistically significant difference in the amount and rate of incisor intrusion achieved among the three groups (p >0.05). CLINICAL SIGNIFICANCE: Significant amount of incisor intrusion was carried out by all the three methods. There was no statistically significant difference in the amount and rate of incisor intrusion achieved by the three methods. Clinically, mini implants can be considered superior to the conventional techniques as it provides absolute anchorage which eliminates unwanted effects of incisor intrusion.

Is aromatherapy associated with patient's dental anxiety levels? A systematic review and meta-analysis.

The use of aromatherapy for the reduction of anxiety levels during dental treatment procedures has been well established in the literature; however, there is limited evidence regarding its efficacy. The present meta-analysis is an attempt to assess the association between the use of aromatherapy and anxiety levels among dental patients. A comprehensive search was conducted across Medline, Scopus, Web of Science, EBSCO host, Cochrane databases, and Google Scholar for studies evaluating aromatherapy and anxiety level among dental patients. PRISMA guidelines were followed for the meta-analysis. Randomized and cluster-randomized trials comparing aromatherapy with controls were included. The random-effects model was used to assess the mean differences in anxiety levels of patients visiting dental OPD. The significance value was set at P < 0.05. Six studies were identified that met the requirements for inclusion. Aromatherapy was significantly associated with reduction in patient anxiety levels during dental treatment (pooled mean difference: -3.36 [95% CI, -3.77 - -2.95, P = 0.00001). Low heterogeneity was noted between studies (I2 = 1%, P = 0.41) analyzed in the meta-analysis. High certainty of the evidence was obtained from the association between the use of aromatherapy and dental anxiety. This meta-analysis suggests that aromatherapy is effective in reducing dental anxiety. When used judiciously, the results of this work should encourage the use of aromatherapy to reduce patient anxiety levels during dental procedures.